By Harry Glazer
Reading a textbook or current medical journal is good. Classroom lectures are fine. Online professional education is useful. But nothing compares to hands-on training, in a real-life scenario, to hone the skills of an active-duty nurse.
The nursing leaders at Parker at McCarrick (PMC) in Somerset, New Jersey understand this fact and have made arrangements to upgrade the professional development opportunities for nursing staff at the home.
Over the summer and early fall Director of Nursing Janet Patullo, Assistant Director of Nursing Nancy Purcell Holmes, and Parker’s Director of Professional Education Lisa Slater investigated local opportunities for PMC nurses to use SIM labs to keep their skills fresh. SIMS labs, often located at medical centers and universities, house high-tech mannequins that can convincingly mimic the various symptoms of a patient in medical distress – eye rolling and uncontrolled shaking indicating a seizure, excessive sweating and high blood pressure to show the signs of a heart attack, and a dozen other medical crisis conditions as well.
After reviewing different options, the group decided to forge a relationship with the SIM Lab at St. Peter’s University Hospital in New Brunswick. The St. Peter’s SIM Lab, led by Dr. Nayan Kothari and the Clinical Education, Nursing Research Team, responded enthusiastically to the PMC inquiry and a partnership was born.
In mid-October, a group of eight nurses from PMC came to St. Peter’s for the first encounter with the SIM Lab. Jim Spaulding, BSN, RN, CCRN, presented a one-hour refresher on head-to-toe physical assessment, congestive heart failure, and the most effective interventions. Then the group were introduced to the two SIM mannequins, one male and one female, and practiced the interventions.
The PMC nurses marveled at the life-like qualities of the mannequins. And the nurse leaders were delighted with the effectiveness of the training.
In the weeks ahead, Parker at McCarrick nursing staff will visit the St. Peter’s SIM Lab, in small groups, so that all of the homes’ RNs and LPNs will have participated in the one-hour congestive heart failure course and practiced with the SIM mannequins. Subsequent classes and practice sessions are already planned for the months ahead, to provide hands-on training in Sepsis and Chronic Obstructive Pulmonary Disease (COPD) management.
“This partnership is a tremendous benefit to our nurses,” says Janet Patullo, Director of Nursing at Parker at McCarrick. “You can see, at the end of each class, how their familiarity with the ‘right’ procedures grows and their confidence in a crisis situation increases as well. We are grateful to St. Peter’s for partnering with us for this state-of-the-art training.”
By Daniel Carr
While we are thankful every year for our many blessings, 2017 stands out among the rest. This year, Parker’s 110th anniversary falls on Thanksgiving Day. We feel proud of all our accomplishments since Henrietta Parker opened Parker at Landing Lane in 1907. We are especially thankful for such a monumental year – we are serving more people than ever, emboldened by our new mission of making aging part of life.
The uplifting sense of gratitude is tangible during this time of the year, and it results in the desire to help out others who are not as fortunate. Parker at Stonegate has been working to raise funds for Susan G. Komen and create toys for Marty’s Place Senior Dog Sanctuary. Parker at River Road has been collecting clothing donations for Elijah’s Promise, and Parker at McCarrick has been accepting non-perishable food for the Franklin Park Food Bank, as well as fundraising for St. Jude’s Children’s Hospital.
This week, all of our residences are proudly displaying “Thanks for Giving” trees, where everyone is encouraged to write a small message on a leaf describing what they are thankful for, and then placing it on the tree like an ornament. In only a few days, the trees are sprinkled with positive messages. You can often find either an Elder or one of our care partners stopping in their tracks to read some of the positive words placed on the tree. It’s a small way we try to express both gratitude for and unity with those around us.
We’re also thankful to have entered the national conversation on aging as a “thought leader” in the industry. We’re happy to be of service to so many people and are grateful for our residents, program participants, employees, care partners, and others who help us fulfill our mission of making aging manageable, relatable and enriching for all of society.
This month, I was interviewed by a reporter from Latinas in Business magazine for an article about how Latinos age in this country and the issues, both cultural and economical, that impede providing the best aging services possible for this growing population.
The article, “The Hispanic Paradox,” was recently published; I’m proud to share it with you, and I look forward to your comments.- Roberto
By Susana G. Baumann
As the baby-boomer population increases, Latinos aging in America have become a “good news-bad news” kind of topic. On one side, Latinos continue to puzzle doctors and researchers by aging at a slower rate than other ethnic groups, a phenomenon called “the Hispanic Paradox.” On the other, evidence of health disparities, lack of health insurance and poverty levels make them a vulnerable group that requires special attention from policy makers and healthcare providers alike. We interviewed Roberto Muñiz, President and CEO of Parker, to help us understand how Latinos age in America.
The findings of a UCLA study published in Genome Biology may help scientists understand how to slow the aging process for everyone. It seems that Latinos age more slowly at a molecular level, explained Steve Horvath, a professor of human genetics at the David Geffen School of Medicine at UCLA, and these findings might be used in future aging research.
Researchers believe that Hispanic culture might contribute to this phenomenon – including being closer to their families, keeping fresher food in their diets with less fast food, and manual labor keeping workers in better shape.
Nobody more qualified to speak to this topic than Roberto Muñiz, who for nearly 20 years has been President and CEO of Parker, a best in class, non-profit, New Jersey-based aging services organization that recently celebrated its 110th anniversary. This long-term experience in the aging sector makes Muñiz the ideal expert to discuss how the Latino community views aging-especially cultural nuances such as potential stigma around nursing homes and assisted living facilities vs. living at home or with one’s family.
How do Latinos feel about aging?
“Latinos embrace aging and see it as a natural progression of life,” Muñiz told LatinasinBusiness.us. “They value family interactions and usually have a large, very close-knit family where the younger ones understand that they will eventually take care of the aging members,” he added.
Coming from a big family with six sisters, Muñiz recalls that there was always someone able to care for their mother. As she got older, she appreciated having family around.
“Latinos do, however, still fear aging because they have a higher rate of chronic health conditions, such as diabetes and obesity, than other ethnic groups. Regardless of this, Latinos really make aging part of life and tend to feel comfortable with that new stage,” he stated.
Latinos aging in America and nursing homes
Research shows current nursing home admission rates for Hispanics are far below levels for other ethnic groups. Hispanics accounted for 5.5 percent of all nursing homes residents in the U.S. in the first quarter of 2016, according to government data.
“Hispanics have traditionally used formal long-term care services less than other US ethnic groups. They are less likely than Caucasians and African Americans to live in nursing homes and use of home health aides,” Muñiz explained.
Difficulty communicating because of cultural or language barriers is one of the factors contributing to their lower use of long-term care services. Traditionally, children, mainly women, take on the role of caregivers in a family.
However, as times change and more women are joining the workforce, there has been an increase in family members being placed in nursing homes or assisted living in America. “This trend is still observed in Latino families, but to a lesser extent,” Muñiz said.
“Since culturally Latino families feel the responsibility to care for their loved ones at home, many tend to feel guilty because they place a lot of emphasis on family unity,” he explained. “It is uncomfortable for them not knowing how their elders are being taken care of, but they recognize that although they’d prefer to support them themselves, the younger members have to work and deal with their own families issues,” Muñiz added.
Options for Latinos placed in assisted living and nursing facilities
Assisted living and nursing facilities in the U.S. are usually established by for-profit organizations. Although most nursing homes participate in the Medicaid programs, Medicaid is not accepted in most assisted living organizations, making it very expensive for those who cannot afford these services when they are most needed.
“Assisted living facilities are regulated by each State but they are less regulated in comparison to nursing homes,” explained Muñiz. And he continued, “Each state has different requirements; for instance, in New Jersey, regulations require that assisted living facilities that have been in operations for longer than three years must allocate at least 10 percent of their units for residents who are Medicaid eligible, allowing individuals with limited resources to participate in the State Medicaid waiver program,” he indicated. Raising awareness of these regulations is extremely important so that families can take advantage of this option.
Regarding nursing facilities, elderly Hispanics, more than non-Hispanics, depend more of nursing homes that are located in inner cities where typically Hispanics tend to reside, making it more accessible to family members. However, these facilities are usually characterized by severe deficiencies in performance, understaffing and poor care.
Role of “abuelas” in the Latino family
Due to salary gaps, educational disadvantages and lesser work opportunities, Latinas carry these disadvantages into retirement. These economic circumstances have given “abuelas” a key role in the family.
“The “abuelas” contribute by helping with the children while parents are working,” Muñiz said. “Regardless of where the grandmother lives, she’s still the matriarch of the family and many times responsible for instilling core family values. Their relationship with their grandchildren is sometimes even stronger than the kids’ relationships with their parents. This connection may be affected when grandparents are placed in nursing homes or assisted living, but nevertheless grandparents are seen as the backbone of the Latino family.” Muñiz assured.
What Latinos aging in America expect from their future
Latinos aging in America have added a new challenge to the country’s already steep rise in its elderly population as baby boomers enter their retirement years. Policymakers must prepare for this shift in the aging population, as it is expected that by 2050, long-lived Hispanics will account for nearly 20 percent of those older than 65, four times the five percent they represented in the year 2000. However, it might help that a nationwide survey conducted by Parker found that 72 percent of Hispanics do not fear or worry much about aging at all, and 57 percent of Hispanics think of aging in positive ways using words like “hopeful,” “relevant,” and “vibrant.”
By Harry Glazer
Parker’s Day Club at Home visits four Middlesex County senior residences each week and provides four hours a day of creative, interactive, and fun activities to stimulate the minds, bodies, and imaginations of senior citizens. The sole staff person and program manager, Laurie Peters, is a dynamo with a singular focus – to engage with all the people she serves and add joy to their lives. In the last week of August, Laurie celebrated the end of summer in each of the residences with an island-themed party, complete with non-alcoholic Pina Coladas, a blind taste test of foods from the islands, and fun games.
One of the games they played was ‘Tacky Tourist,’ in which each member of a team had to go to one table and put on a button down shirt, a lei, hat, sunglasses, and (pretend to apply) suntan lotion, then go to another table and take off all the ‘vacation’ items. The team whose members dressed and discarded the summer clothes the quickest won. As you can see from this photo, Laurie (in the white shirt) and her party guests had a grand ole time.
By Roberto Muñiz, President & CEO
In its September issue, Conde Nast fashion and beauty magazine Allure announced that it will no longer use the term “anti-aging” in its pages. Writes the publication’s editor-in-chief, Michelle Lee: “This issue is the long-awaited, utterly necessary celebration of growing into your own skin—wrinkles and all. . . But changing the way we think about aging starts with changing the way we talk about aging.” Ms. Lee bravely holds to account the magazine industry for its role in promoting anti-aging stereotypes. “Whether we know it or not, we’re subtly reinforcing the message that aging is a condition we need to battle—think antianxiety meds, antivirus software, or antifungal spray.”
While acknowledging that “Americans put youth on a pedestal,” the editor implores readers to “agree that appreciating the dewy rosiness of youth doesn’t mean we become suddenly hideous as years go by.” Seventy-two-year-old, Academy Award-winning cover girl Helen Mirren (The Queen) is held up as an exemplar popular figure “who’s embodied sexiness for nearly four decades in Hollywood without desperately trying to deny her age.”
Online, the magazine has launched a range of interactive features to support its campaign, including a gallery of 29 celebrities who are taking a stand against anti-aging that features the likes of Cate Blanchett, Yoko Ono, actress and Supermodel Andie MacDowell (“I dated a guy recently who said I looked really good for my age. I was like, why not just, ‘You look really good’? I never went out with him again.”), and Drew Barrymore (“When I look at women who have not messed with fillers or Botox, I love looking at their face[s]. I love the grace and the story that women are telling by aging naturally.”).
These interactive features also include video segments with Betty, 101, and Helen, 104, in which these two cool centenarians are asked the secret to happiness and longevity. “If there’s one inevitability in life, it’s that we’re getting older,” Ms. Lee concludes. “Repeat after me: Growing older is a wonderful thing because it means that we get a chance, every day, to live a full, happy life.”
Allure’s campaign is equally moving, inspirational, and bold; our great hope is that other influencers will follow in taking up this cause. The call to action issued by the popular magazine is especially heartening to us here at Parker, given all that we do each and every day to help change perceptions about aging and empower older Americans—whether partnering with universities; expanding services from traditional models; embracing connectivity through technology, and off-campus programs and community partnerships. Around here, we call it #WithIt, and we applaud Allure for helping to make aging part of life.
By Roberto Muñiz
At Parker, we've always known that aging is a positive thing, a fantastically exciting phase of life synonymous with richness of experience, relevance, and vitality. We don't just talk the talk, but walk the walk when it comes to the changing conversation around aging in America – so we launched a nationwide survey to hear how people across the country really feel about growing older.
We were excited with the results-which confirm that the nation is rapidly changing its attitude about aging and embracing this part of life like never before. Among the most surprising survey findings, 71% of Americans do not fear or worry about aging very much at all! In fact, nearly half of those we spoke with (49%) use upbeat language and words including "hopeful," "relevant," and "vibrant" to describe the experience of growing older in America today.
Almost 78% of Americans do not consider people in their 50s or 60s to be "old." Indeed, if you're a fan of Ruth Bader Ginsberg, Warren Buffet, or master yoga instructor Tao Porchon-Lynch, you'll be pleased to learn that our survey found that the vast majority of Americans (62%) believe that 80 isn't too old to serve in government, be the CEO of a Fortune 500 company, or practice and teach yoga.
What was especially heartening about our survey was that each of these findings was remarkably consistent across gender, race, ethnicity, geography, and household income and education levels. That means, America is getting on the same page when it comes to a more positive and progressive view of aging.
Is there work to be done to continue to help shift people's perspectives about growing older, and challenge misperceptions about ageism (like the one about older adults not willing to adopt new technology)? Absolutely. In fact, nearly two-thirds of those surveyed (59%) feel that not enough technology today focuses on the lifestyles of older people-a powerful consumer demographic that is embracing tech and social media like never before.
We plan to revisit Parker's "Aging in America" survey each year to track the conversation-a conversation in which we all have an important role to play (#WithIt). For now, our first annual survey is a powerful proof point that confirms what we've seen and experienced in our communities for years. The conversation around and about aging is changing, and America is listening.
By Erin L. Carlucci, RN, CPT, CDP
Today I saw a smile. You may be thinking, “Smile? We all see smiles.” This smile was different. This smile was the smile of a wonderful memory. A memory that isn’t as attainable for her as it is for us. This smile shared a moment of who she is and not what she has, dementia. As she caressed the leaves ever so gently and felt the soft warm soil run through her fingers, she smiled. She smiled and began to talk about the farm. She was the best darn farmer you ever did know. She planted eggplants, zucchini, basil, and carrots. Oh but the eggplants… they were her pride and joy, award winning even. She spoke about the town fair and how her eggplants were the most vibrant in color and weighed the most. For a moment she was back. Her eyes sparkling with pride, and her smile as wide and beautiful as the Pacific Ocean on a hot summer day! Could it be that something as sim-ple as a plant and soil has the ability to bring so much joy? We know sensory touch can bring positive feelings if one of the five senses has been stimulated: Visual, verbal/hearing, touch, smell or taste. But how do plants and nature come into play?
With gardening you can plant a seed and watch the cycle of the plants growth, water an already bloomed flower, enjoy the colors and scents around you, hear the buzzing bee as it drinks the sap from a flower, touch the smooth skin of an eggplant, the rigged bumps on asparagus or the curved ridge of a carrot, eat what has already grown or talk to help it grow. Most importantly, gardening requires one’s nurturing thus feeding the spirit and removing the helplessness that a person living with dementia may feel. I’m not an expert in horticulture but I know a special smile when I see one. Today I saw a smile and this smile was different. This smile showed me who she is and not what she has!
Erin Carlucci is the Community Nurse Manager, Staff Education & Development for Parker at Monroe.
Photo Credit: Jim, The Photographer, Flickr.com
By Yolanda Golebiowski, BSN, RC-BC, RAC-CT, CDP, Eden Associate
Practicing Mindfulness is as any training we decide to engage in. Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not become overly reactive or overwhelmed by what’s going on around us.1 Most of us are familiar with the Buddhist form of meditation, as well as the Contemplative Psychotherapy training, we foster mindfulness in a sitting position, cross-legged. Being in the present is more than seeking a quite space to meditate; it is the key to overcoming distress, negativity, and helps to understand the present moment and program in ourselves a sense of that which is right.
When we are mindful, we show up for our lives; we do not miss them in being distracted or in wishing for things to be different. Instead, if something needs to be changed we are present enough to understand what needs to be done. Being mindful is not a substitute for actually participating in our lives or profession and taking care of our own and other’s needs. In fact, the more mindful we are, the more skillful we can be in compassionate action.2
Our brains are assembled with the amygdala and limbic system to notice threats; these active parts of the brain are cognitive in nature. Whether we are a person that sees an empty glass, a glass half full or ready to enjoy the drink. We must remember that, we are not made by our thoughts.
Mindfulness is not obscure or exotic. It’s familiar to us because it’s what we already do, how we already do, how we already are. It takes many shapes and goes by many names. Buddha taught that the source of suffering is our attempt to escape from our direct experience. First, we cause ourselves suffering by trying to get away from
pain and attempting to hang on to pleasure. Unfortunately, instead of quelling our suffering or perpetuating
out happiness, this strategy has the opposite effect. Instead of making us happier, it causes us to suffer.
Second, we cause suffering when we try to prop up a false identity usually known as ego, this, too does not
help and leads to suffering.3
Remember that time you really embarrassed yourself, and you play it over and over in your head, cringing
a little each time? Or how about your inabilities to ask for a raise or promotion you deserve because you
have told yourself so many times you are not worth it? You let it stew, creating resentment that is a product
of your own doubts.
Repeated negative thought patterns are a strangely comfortable nemesis we keep at all times, if for no other
reason than that they are familiar. Yet, intuitively, you understand that replaying a cringe worthy historical
event repeatedly in your head is unhelpful, if not harmful. Similarly, telling yourself that you are not worth
the raise when the underlying driving force is that you have a terrible sense of self worth is nothing more
than a negative thought pattern that can be quite destructive.
How does one break these patterns? Mindfulness continues to be a source of research and how it affects
our behavior. Some recent research about mindfulness looked at the effect of mindfulness on negative
thought patterns. Mindfulness is a useful tool for noticing and extracting yourself from the cycle of unhelpful
thoughts.4
Dr. John Paul Minda is a professor of psychology at the University of Western Ontario in London, Ontario,
who studies cognition and thinking as well as mindfulness. Minda pointed to some recent research by
Lindsay and Cresswell on mindfulness and attention monitoring. “One possibility is that mindfulness
meditation can help people to be more attentive to their own emotions,” he said. “By being aware of negative
feelings as soon as they arise, people can engage in positive remediation rather than dwelling on the
negative cognition.” By cultivating mindfulness, we can learn to identify the negative thoughts that keep
us trapped in feelings of self-doubt and shame, and learn instead to embrace the peacefulness that stems
from living in the present moment. Mindfulness is also know as emotional intelligence.
As nurses we take in everyone’s problems and many forms of negativity surround us. This creates feeling
of vulnerability and threats that take a toll on our emotional wellbeing. Whether it is a person worrying
about consequences contemplated at work, or relationships in general, these feelings stem from our human
brains reacting in all cases. Stephen Colbert’s satirical book titled March to Keep Fear Alive depicts how
humans embraced fear in order to survive as our ancestors did. The article in Psychology Today also makes
reference to our brain reactions being a product of our evolution. As it turns out, the negativity bias aided
our ancestors in making intelligent decisions in high risk situations.
Understanding our brain reaction and not permitting to be hijacked by fear is the first step to mindfulness.
Then, by cultivating a mindful awareness to how your brain reacts to feeling threatened, we can simulate
and therefore build up the neural substrates of a mind that has more calm, wisdom and sense of inner
strength. A mind that sees real threats more clearly, acts more effectively in dealing with them, and it is less
rattled or distracted by exaggerated, manageable, or false alarms.5
Rick Hanson, a neuroscientist and psychologist, gives three simple steps to mindfulness:
- Look for good facts and turn them into good positive experiences.
- Making a conscious effort to look for positive aspects in every experience and practicing every day, it will become a habit.
- Savor the experience
- Attend to positive experiences, by elongating our positive sensations, we allow more neurons to fire and wire together in response to the positive stimulus. This solidifies the experience in our memories.
- Intend and sense that the good experience is sinking into you
- Being aware of how the different positive experiences affect us, we have cultivated emotional intelligence.
One cannot be emotionally intelligent without mindfulness of one's emotions and without sound and consistent emotional intelligence, one's happiness is merely a mirage in the desert, seen but never truly reached.
1 https://www.mindful.org/meditation/mindfulness-getting-started/
2 https://health.clevelandclinic.org/2017/01/turn-around-negative-thinking/
3 https://www.psychologytoday.com/blog/the-courage-be-present/201001/how-practice-mindfulness-meditation
practice-mindfulness-meditation
4 https://www.forbes.com/sites/jeenacho/2016/12/27/the-science-behind-how-mindfulness-helps-you-to-break-negative-thoughtpatterns/#6179d0974119
5 http://www.rickhanson.net/how-your-brain-makes-you-easily-intimidated/
Yolanda Golebiowski is Director of Nursing at Parker at Monroe.
Photo Credit: Thomas Galvez, Flickr
Parker recently conducted a national survey to gauge changing perceptions around aging in America. What we discovered may surprise you!
- 71% of those surveyed do not fear or worry about aging.
- A vast majority of those surveyed (62%) feel that 80 is not too old to serve in government, run a marathon, be CEO of a Fortune 500 company, or practice yoga.
- Those surveyed were evenly split (49% each) in describing the experience of growing older in America today with positive words (e.g., “hopeful”) vs. negative words (e.g., “depressing”).
- Only 22% of Americans consider people in their 50s and 60s to be “old.”
- Nearly two-thirds (59%) of Americans feel that not enough technology innovation focuses on the lifestyles of older people.
Survey Methodology
The national, statistically relevant Telephone CARAVAN® survey was conducted by ORC International from March 23-26, 2017, using two probability samples: randomly selected landline telephone and mobile (cell) telephone numbers. The combined sample consists of 1,018 adults (18 years old and older) living in the continental U.S., with a margin of error of +/- 3% at 95% confidence level.
Visual concept: It was important to Parker—and its NYC branding agency, Ideon—to celebrate the organization’s history while looking forward. The goal was to represent Francis E. Parker’s commitment to family, community, and service, and visually preserve the past while bringing that vision forward to the modern day.
Logo “Lock-up”: Parker’s name and tag line support one another and are meant to be seen together. Our tagline, “we make aging part of life,” which is also our vision, nods to what Parker is doing on a national thought leadership level, in addition to operationally. The word “life” appears in the same color as “Parker”; a visual echo that indicates how Parker embraces life and also suggests how the experience of “Parker life” differs from anywhere else.
Signature: From royal seals to the Declaration of Independence to today, a signature signifies something a person believes in, honors, and validates. Using cursive suggests Francis E. Parker’s seal of approval; the handwritten feel of the font symbolizes ownership, value, and the kind of personalized care for which Parker is well-known.
The Parker Edge: The 15-degree angle of ascent comes as a visual rebuke to misconceptions that getting older means growing more stagnant and sedentary. Our signature moving upward from lower left to top right suggests activity, hope, and aspiration.
Color: We selected poppy as our primary color because it captures Parker’s values: creative, enriching, and vibrant. In addition, this bold and rousing color is the opposite of the clichéd, soft, pastels we see in the aging services space. For our secondary color, we chose iris navy blue to speak to Parker’s rich history and legacy.